Congenital Short Femur and Fibular Hemimelia Staged Approach Frame and Nail

This case illustrates the management of leg length discrepancy and mechanical axis malalignment in the context of a skeletally immature patient with femoral deficiency and fibular hemimelia. This patient’s care featured principles of growth prediction, staged intervention with attention to preserving physeal growth, and the use of external hexapod and intramedullary nail lengthening. A noteworthy point for this patient is that despite his tibial valgus being corrected gradually, he nonetheless developed a peroneal nerve palsyPeroneal nerve palsy; prompt release relieved symptoms and allowed corrections to goal.